Background: Assessment of chest radiographs is a fundamental clinical skill, often taught opportunistically. Medical students are taught how to read adult chest radiographs; however, in our experience, there is often a lack of structured training for the interpretation of paediatric chest radiographs.Aims: Our aim was to develop and evaluate a novel online approach to teach medical students how to interpret paediatric chest radiographs.Method: Ericsson’s expertise acquisition theory was used to develop 10 sets of 10 practice radiographs, which were graded using the X-ray difficulty score. Medical student volunteers were recruited in the paediatric rotation of their first clinical year and were asked to write an interpretation of the chest X-ray, which was then compared to an official report for accuracy. Pre- and post-training tests of identical difficulty were offered to analyse improvement in the accuracy of reports following training. A semi-structured focus group was conducted after the tests, the transcription of which was analysed using grounded theory.Results: Of 117 students in the year, 54 (46%) originally volunteered. The engagement was initially high but dropped during the year, particularly during the pre-examination block. The high drop-out rate made the quantitative measurement of effectiveness difficult. Despite this challenge, students found the system helpful and reported feeling more confident in their ability to interpret paediatric chest x-rays, and provided transferable skills to other elements of their study. The focus group suggested that the pressure of other work, exam preparation, technical factors, and the inflexibility of the study protocol reduced engagement.Conclusion: Although the topic covered was seen as important and relevant to exams, the current system requires development to make it more effective and engaging. Despite insufficient data to draw quantitative conclusions, students found the system helpful and reported feeling more confident in their ability to interpret paediatric chest X-rays.
